| NPI | 1891013918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R3404) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA 60446429) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2021-01-05 |