| NPI | 1932490778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME119510) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME119510) |
| 207Q00000X Family Medicine (Licence: TX R3043) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2018-11-12 |