| NPI | 1427181536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD60077649) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA a97906) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2022-01-28 |