| NPI | 1104189356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301102348) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: HI 21172) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2024-01-22 |