NPI | 1386905917 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD60847731) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR pg158620) |
Enumeration Date | 2012-05-30 |
Last Update Date | 2018-06-28 |