NPI | 1912358490 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NE 32640) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MN 62694) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NE 32640) | |
207ND0900X Dermatology, Dermatopathology (Licence: NE 32640) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: NE 32640) | |
207R00000X Internal Medicine (Licence: NE 7797) | |
Enumeration Date | 2016-06-27 |
Last Update Date | 2022-11-01 |