NPI | 1265878789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: OK 6265) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2016034327) |
207N00000X Dermatology (Licence: TX R3974) | |
Enumeration Date | 2013-05-13 |
Last Update Date | 2020-03-18 |