| NPI | 1255602207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX R5814) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX R5814) |
| 207N00000X Dermatology (Licence: FL OS11954) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS11954) | |
| 207R00000X Internal Medicine (Licence: FL OS11954) | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2018-07-12 |