| NPI | 1053522573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV 1335) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NV 1335) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA 20A8338) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 3795) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WY 8013A) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2014-08-12 |