| NPI | 1508206921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS17863) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS17863) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: OH 34.013438) | |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2025-06-12 |