NPI | 1972636272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A92548) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A92548) |
207N00000X Dermatology (Licence: IA 37075) | |
Enumeration Date | 2007-03-14 |
Last Update Date | 2013-09-11 |