| NPI | 1174729966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 48678) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD433585) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2021-12-22 |