| NPI | 1104270511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 292713) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 292713) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2023-10-06 |