NPI | 1083818884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX N3493) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PR 26080R) |
207ND0900X Dermatology, Dermatopathology (Licence: TX N3493) | |
Enumeration Date | 2007-06-14 |
Last Update Date | 2022-07-21 |