| NPI | 1578094785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA a160666) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A160666) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2025-10-16 |