| NPI | 1669977542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A165234) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A165234) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A165234) | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2025-09-15 |