NPI | 1396955076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 41487) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 41487) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2017-08-16 |