| NPI | 1093733495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD00046521) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD00046521) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-01-29 |