| NPI | 1740535707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX R1540) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A130568) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2021-01-19 |