| NPI | 1811256530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD458296) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX S1784) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2024-02-09 |