| NPI | 1639445950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 29354) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NE 29354) |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: NE 29354) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: NE 29354) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2019-03-04 |