| NPI | 1306200662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A172167) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME162204) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME162204) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A172167) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2025-09-17 |