NPI | 1588710834 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA G44627) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G44627) |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA G44627) | |
Enumeration Date | 2007-01-26 |
Last Update Date | 2021-06-29 |