NPI | 1740574169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR MD195049) |
Additional Taxonomies | 207N00000X Dermatology (Licence: OR MD195049) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 2862881) | |
Enumeration Date | 2011-06-02 |
Last Update Date | 2021-01-02 |