| NPI | 1467485250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 0101250148) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101250148) |
| 207N00000X Dermatology (Licence: WI 1765) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-10-05 |