| NPI | 1689875825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301087723) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX N3326) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX N3326) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2011-07-20 |