| NPI | 1700091113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CA A104213) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 57.007895) |
| 207N00000X Dermatology (Licence: CA A104213) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2023-09-22 |