| NPI | 1720321268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NC 2012-02881) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A129524) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2022-02-21 |