| NPI | 1609087774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 238976) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 238976) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-05-14 |