| NPI | 1508988064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA C135929) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 243118) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MA 243118) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2021-11-29 |