| NPI | 1376710913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: LA MD.203192) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX Q9754) |
| 207N00000X Dermatology (Licence: LA MD.203192) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX Q9754) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: LA MD.203192) | |
| 208D00000X General Practice (Licence: LA 203192) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2022-06-02 |