| NPI | 1659303444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN MD 31221) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN md31221) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-10-06 |