| NPI | 1063869352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL MD39251) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME149913) |
| 207N00000X Dermatology (Licence: GA G39107A) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA G39107A) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2026-01-28 |