| NPI | 1700265576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WV 3588) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NV DO2748) |
| 207N00000X Dermatology (Licence: TX R0204) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2020-10-06 |