| NPI | 1720320385 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R6760) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.063329) | 
| Enumeration Date | 2013-03-21 | 
| Last Update Date | 2018-08-15 |