NPI | 1639639339 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA OP61674158) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR DO224737) |
207N00000X Dermatology (Licence: WA OP61674158) | |
207N00000X Dermatology (Licence: OR DO224737) | |
Enumeration Date | 2019-03-20 |
Last Update Date | 2025-09-24 |