| NPI | 1487061537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD471094) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2015015406) |
| 207N00000X Dermatology (Licence: TX S0921) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: PA MD471094) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2020-10-21 |