| NPI | 1174637433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 41853) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MS 19882) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: TN 41853) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MS 19882) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-10-21 |