| NPI | 1285715300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CT 70355) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 70355) |
| 207N00000X Dermatology (Licence: VA 0101257918) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2022-07-01 |