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 | 2024-08-15 |