| NPI | 1164406369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 33568) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 33568) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2020-08-14 |