NPI | 1811154057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0069907) |
Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD035598) |
207N00000X Dermatology (Licence: VA 0101249291) | |
Enumeration Date | 2008-05-16 |
Last Update Date | 2012-05-17 |