| NPI | 1588710834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G44627) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G44627) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA G44627) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-06-29 |