| NPI | 1306159728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 2794) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 2794) |
| 208D00000X General Practice (Licence: VA 0116023040) | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2020-12-03 |