| NPI | 1376779710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: FL OS 10617) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS10617) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2023-07-19 |