| NPI | 1699978643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207NS0135X Dermatology Procedural Dermatology | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2007-07-08 |