| NPI | 1043445620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 27119) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 62088-20) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OK 27119) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WI 62088-20) | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2022-08-15 |