| NPI | 1174786693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301092237) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301092237) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MI 4301092237) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-10-20 |