| NPI | 1558927970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD486140) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AL 46170) |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2025-06-02 |