| NPI | 1518958297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 79526) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: MA 79526) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-12-13 |