NPI | 1497214233 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA11780700) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA11780700) |
207N00000X Dermatology (Licence: PA MD490340) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2025-09-15 |