| NPI | 1003011404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO CDR.0000100) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2007016662) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: KS 04-34976) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 63895) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CO CDR.0000100) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-10-12 |