NPI | 1801242292 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: DC MD210001378) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TN 60585) |
Enumeration Date | 2016-05-04 |
Last Update Date | 2021-08-10 |