| NPI | 1548448277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 171322) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 171322) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 171322) | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2016-03-16 |