| NPI | 1902962954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G76233) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G076233) |
| 207N00000X Dermatology (Licence: TX S6378) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-09-27 |