| NPI | 1578741732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NJ 25MB08611500) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA OT010168) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: OK 4608) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: OK 4608) | |
| 207N00000X Dermatology (Licence: OK 4608) | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2014-09-28 |