| NPI | 1720012875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G60552) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CA G60552) |
| 207ND0900X Dermatology Dermatopathology (Licence: CA G60552) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CA G60552) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-08-30 |