NPI | 1134321037 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: GA 065765) |
Additional Taxonomies | 174400000X Specialist (Licence: GA 065765) |
207N00000X Dermatology (Licence: GA 065765) | |
Enumeration Date | 2007-06-03 |
Last Update Date | 2022-06-24 |