| NPI | 1518227800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 271655) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 265707) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 271655) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2020-09-30 |