| NPI | 1619900388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME74763) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME74763) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME74763) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL ME74763) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-04-11 |