| NPI | 1679745657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME113001) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME113001) |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2017-12-21 |