| NPI | 1659428472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 45062) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN MD45062) |
| 207N00000X Dermatology (Licence: CT 48930) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-03-31 |