NPI | 1174915987 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: OH 34.012494) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS14719) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS14719) | |
Enumeration Date | 2015-03-03 |
Last Update Date | 2022-03-26 |