| NPI | 1588082200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 275273) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: RI 16273) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2020-11-16 |