| NPI | 1417479882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 95927) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.146581) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35.146581) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: GA 11670) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214596) | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2023-06-22 |