| NPI | 1457374704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 227196) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME163439) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME163439) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 227196) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-08-22 |