NPI | 1073773867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX N2335) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME106298) |
207N00000X Dermatology (Licence: DC MD038210) | |
207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: TX N2335) | |
Enumeration Date | 2008-06-15 |
Last Update Date | 2020-09-23 |