| NPI | 1720436397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 5101026056) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OR DO184772) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR DO184772) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2023-03-07 |