| 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 | 2025-10-29 |