| NPI | 1760878029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T1525) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NV 18488) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-09-30 |