| NPI | 1700818515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME92484) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: FL ME 92484) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-04-28 |