| NPI | 1376717363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60048520) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: WA MD60048520) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2022-10-14 |