| NPI | 1578555637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 37744) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: UT 294519-1205) |
| 207N00000X Dermatology (Licence: UT 294519-1205) | |
| 207ND0900X Dermatology Dermatopathology (Licence: CO 37744) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: UT 294519-1205) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: CO 37744) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: UT 294519-1205) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CO 37744) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2017-11-07 |