| 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 |