| NPI | 1689857427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NC 201000776) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 201000776) |
| 207N00000X Dermatology (Licence: MO 2008006404) | |
| 207N00000X Dermatology (Licence: DC 137689) | |
| Enumeration Date | 2007-12-16 |
| Last Update Date | 2022-06-20 |