| NPI | 1679708416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME119445) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME119445) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2019-01-26 |