NPI | 1174626600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 0101055502) |
Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101055502) |
Enumeration Date | 2006-09-07 |
Last Update Date | 2024-05-08 |