| NPI | 1467437152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 31198) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: AZ 31198) |
| 207ND0900X Dermatology Dermatopathology (Licence: AZ 31198) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: AZ 31198) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: AZ 31198) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2023-09-07 |