| NPI | 1205255288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A135075) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CA A135075) |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: CA A135075) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CA A135075) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2025-01-30 |