| NPI | 1124223011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 2011007277) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: MO 2011007277) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2021-02-22 |