| NPI | 1396993663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MS 21609) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 5094) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2014-02-11 |