NPI | 1285262170 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 78540) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MN 78540) |
Enumeration Date | 2020-03-28 |
Last Update Date | 2025-07-14 |