| NPI | 1790079184 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R3729) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI MD15065) | 
| Enumeration Date | 2011-06-03 | 
| Last Update Date | 2025-04-14 |