NPI | 1700371960 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 295603) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 176004) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 71417) | |
Enumeration Date | 2018-06-28 |
Last Update Date | 2024-01-22 |