NPI | 1194110874 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX S0986) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TX S0986) |
Enumeration Date | 2015-03-31 |
Last Update Date | 2022-03-31 |