| NPI | 1356441869 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A75794)  | 
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CA A75794)  | 
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A75794)  | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA A75794)  | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A75794)  | |
| Enumeration Date | 2006-09-24 | 
| Last Update Date | 2023-10-30 |