NPI | 1225488208 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD61394963) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-06-21 |
Last Update Date | 2024-09-27 |