| NPI | 1386808368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 51420) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 51966) |
| 207N00000X Dermatology (Licence: ND 12323) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2016-07-11 |