| 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 | 2020-08-05 |