| NPI | 1063484988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G64015) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: HI MD9123) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G64015) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: HI MD9123) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2007-07-08 |