| NPI | 1205975240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD60207521) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A88217) |
| 207N00000X Dermatology (Licence: CT 048561) | |
| 207N00000X Dermatology (Licence: WA MD60207521) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-01-12 |