| 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 |