| NPI | 1285695122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA OS006160L) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OK 4575) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: OK 4575) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2013-06-13 |