NPI | 1326041922 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN MD42920) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TN MD42920) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX L9659) | |
Enumeration Date | 2005-05-27 |
Last Update Date | 2022-03-26 |