| NPI | 1124014741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G80164) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G80164) |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA G80164) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G80164) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2017-09-29 |