| NPI | 1316034093 |
|---|---|
| Former Name | KATHY LYNN PERISHO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA IA26734) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VT 0420018773) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2025-08-04 |