| NPI | 1679922793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 282881) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 282881) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2026-04-24 |