| NPI | 1164957916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME141236) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME141236) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME141236) | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2022-05-18 |