NPI | 1104906908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0061483) |
Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD034830) |
207N00000X Dermatology (Licence: VA 0101236289) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2014-05-29 |