NPI | 1407943921 |
---|---|
Former Name | PAYAM TRISTANI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: UT 3496681205) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: UT 3496681205) |
207NS0135X Dermatology, Procedural Dermatology (Licence: UT 3496681205) | |
Enumeration Date | 2006-10-06 |
Last Update Date | 2021-12-20 |