| NPI | 1770946196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 72071) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX T0147) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2025-07-25 |