| NPI | 1164886099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 0101274918) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101274918) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2023-07-31 |