| NPI | 1659791069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 299232) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 299232) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 299232) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2021-06-14 |