NPI | 1053602128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 61320) |
Additional Taxonomies | 207N00000X Dermatology (Licence: GA 86364) |
207N00000X Dermatology (Licence: CA A122120) | |
207N00000X Dermatology (Licence: FL ME140586) | |
207N00000X Dermatology (Licence: TN 61320) | |
207P00000X Emergency Medicine (Licence: CA A122120) | |
Enumeration Date | 2011-04-25 |
Last Update Date | 2021-01-19 |