| NPI | 1497100713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 2021023179) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: MO 2021023179) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2022-02-12 |