| NPI | 1689606113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 224302) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NY 238317-1) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: NY 238317-1) | |
| 207N00000X Dermatology (Licence: NY 238317-1) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |