| NPI | 1629054754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 200826) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 200826) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 200826) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2021-04-14 |