| NPI | 1316206584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: KY 48856) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY R3056) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2017-10-02 |