NPI | 1558743732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 287745) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MA 287745) |
207NS0135X Dermatology, Procedural Dermatology (Licence: MA 287745) | |
Enumeration Date | 2015-06-23 |
Last Update Date | 2021-09-17 |