| NPI | 1114039732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME46341) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: FL 46341) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-01-13 |