| NPI | 1568662674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA 307670) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 272698) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D0074076) | |
| 207N00000X Dermatology (Licence: MD D0074076) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2018-01-11 |