| NPI | 1821257189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX S2109) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 245376-1) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2024-06-19 |