NPI | 1033647177 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: SD 12802) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IA R-11289) |
207N00000X Dermatology (Licence: IA R-10928) | |
Enumeration Date | 2017-06-02 |
Last Update Date | 2021-08-09 |