NPI | 1134259104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G084212) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA G084212) |
207NS0135X Dermatology, Procedural Dermatology (Licence: NY 199318) | |
Enumeration Date | 2007-03-07 |
Last Update Date | 2022-07-21 |