| NPI | 1396767893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 69403) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 69403) |
| 207ND0900X Dermatology, Dermatopathology (Licence: GA 69403) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2026-08-03 |