| NPI | 1245644657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD60824359) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD60824359) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2021-01-29 |