| NPI | 1568801801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: VA 0101282519) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101282519) |
| 207N00000X Dermatology (Licence: MD D87568) | |
| 207N00000X Dermatology (Licence: PA MD465025) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD465025) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2025-09-02 |