| NPI | 1427036417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX L9108) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX L9108) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2022-09-15 |