| NPI | 1316331325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR MD198377) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA R-11408) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2020-07-06 |