| NPI | 1134123847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NC 200000409) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: NC 200000409) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2020-10-05 |