| NPI | 1053332130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL me88868) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL me88868) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL me88868) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2012-09-28 |