| NPI | 1154513661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 44537) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 44537) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: UT 13534965-1205) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2024-03-01 |