| NPI | 1568718658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX Q0985) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX Q0985) |
| 207R00000X Internal Medicine (Licence: TX Q0985) | |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2020-07-02 |