NPI | 1144255746 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 233967) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD421829) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2012-07-05 |