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 | 2024-08-06 |