| NPI | 1710026604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N2500) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OK 24559) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-08-10 |