| NPI | 1740589258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 254386) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 254386) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2014-07-02 |