| NPI | 1306820626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MD M35991) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: MD M35991) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-08 |