NPI | 1477599884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2004004910) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: MO 2004004910) |
207NP0225X Dermatology, Pediatric Dermatology (Licence: MO 2004004910) | |
Enumeration Date | 2006-06-22 |
Last Update Date | 2013-01-11 |