| NPI | 1104847334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35088136) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35088136) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2025-06-17 |