| NPI | 1629270897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A119900) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A119900) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2014-01-14 |