| NPI | 1508852799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G58945) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G58945) |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA G58945) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G58945) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2014-05-28 |