NPI | 1003895764 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MD D0064386) |
Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: MD D0064386) |
193200000X Multi-Specialty (Licence: AL 17922) | |
Enumeration Date | 2006-01-11 |
Last Update Date | 2016-08-12 |