| NPI | 1356861637 |
|---|---|
| Former Name | BASIA MARIE MICHALSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 2022016236) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2022016236) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2024-04-25 |