| NPI | 1033478763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: WI 66913-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 66913-20) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: WI 66913-20) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2022-05-18 |