| 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 |