| NPI | 1881708139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T8340) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 58454) |
| 207N00000X Dermatology (Licence: TN 40557) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TN 40557) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TN 40557) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-11-30 |