| NPI | 1477934867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD H0094642) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NE 1588) |
| 207N00000X Dermatology (Licence: VA 0102205717) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2025-05-07 |