| NPI | 1336588136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 290216) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD462041) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MA 290216) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: PA MD462041) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2024-05-10 |