| NPI | 1528300878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 293685) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA a131981) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 293685) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2019-01-11 |