NPI | 1285891168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD153328) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: WA MD60215670) |
207N00000X Dermatology (Licence: WA MD60215670) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: OR MD153328) | |
Enumeration Date | 2008-05-19 |
Last Update Date | 2020-10-01 |