NPI | 1316568538 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX V4728) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TX V4728) |
Enumeration Date | 2020-04-28 |
Last Update Date | 2025-08-26 |