| NPI | 1316328719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MN 71763) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 71763) |
| 207R00000X Internal Medicine (Licence: IL 125066220) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2025-06-10 |