| NPI | 1760988513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 92458) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX T0995) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-03-22 |