| NPI | 1376503946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME74061) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME0074061) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2026-05-19 |