| NPI | 1326602558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD490120) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: PA MD490120) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2025-09-02 |