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 |