| NPI | 1447571518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 262903) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 52761) |
| 207N00000X Dermatology (Licence: NY 262903) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2023-08-02 |