| NPI | 1124175096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 49776) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 49776) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-09-02 |