NPI | 1912058603 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA G032571) |
Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: CA G032571) |
Enumeration Date | 2007-01-16 |
Last Update Date | 2007-07-08 |