| NPI | 1982051942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD470332) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX S9996) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2023-08-21 |