| NPI | 1699976340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD440883) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX N7443) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: PA MD440883) | |
| 207ND0900X Dermatology Dermatopathology (Licence: PA MD440883) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-05-17 |