| NPI | 1164403010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 213284) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 48274) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 48274) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: AZ 48274) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-02-15 |