| NPI | 1063460715 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX H4247) | 
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX H4247) | 
| 207ND0900X Dermatology, Dermatopathology (Licence: TX H4247) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX H4247) | |
| Enumeration Date | 2006-05-05 | 
| Last Update Date | 2019-03-14 |