| NPI | 1124145040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 50518-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD430734) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301105435) | |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2023-08-21 |