| NPI | 1043259856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD00042289) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA 00042289) |
| 207N00000X Dermatology (Licence: WA 00042289) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-01-20 |