| NPI | 1710328851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036-145643) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-062822) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036.145643) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WI 66934-20) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2021-04-20 |