| NPI | 1023165180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: LA MD026331) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: GA 057334) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2008-01-23 |