| NPI | 1033423413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA 35.123120) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 35.123120) |
| 207N00000X Dermatology (Licence: OH 35.123120) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A156592) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35.123120) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A156592) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: OH 35.123120) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2018-08-14 |