NPI | 1417930652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME131008) |
Additional Taxonomies | 174400000X Specialist (Licence: TX K7307) |
Enumeration Date | 2005-11-22 |
Last Update Date | 2022-03-02 |