| NPI | 1457646549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX P2506) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: TX P2506) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: TX P2506) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-03-07 |