| NPI | 1265828362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T2751) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301502324) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX T2751) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301502324) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2023-12-21 |