| NPI | 1710379094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 304947) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 304947) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 304947) | |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2026-05-28 |