| NPI | 1174915987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 34.01294) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS14719) |
| 207N00000X Dermatology (Licence: OH 34.012494) | |
| 207N00000X Dermatology (Licence: FL OS14719) | |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2026-06-04 |