| NPI | 1699754481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME0070174) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME0070174) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2010-09-08 |