| NPI | 1366755530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 2022031229) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2022031229) |
| 207N00000X Dermatology (Licence: IA 40191) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2022-09-07 |