| NPI | 1164501086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 222828) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 222828) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-10-09 |