NPI | 1174586481 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME0046345) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME46345) |
Enumeration Date | 2006-04-08 |
Last Update Date | 2023-03-07 |