| NPI | 1023054624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX M0820) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX M0820) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2008-05-22 |