| NPI | 1972601508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 1664261205) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: UT 1664261205) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-11-11 |