NPI | 1699806539 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: LA 046908) |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 14822R) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2008-07-16 |