| NPI | 1689720278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A93058) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A93058) |
| 207N00000X Dermatology (Licence: CA A93058) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A93058) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2012-07-30 |