| 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 |