| NPI | 1740692326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 59816)  | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 59816)  | 
| 207R00000X Internal Medicine | |
| Enumeration Date | 2014-05-29 | 
| Last Update Date | 2022-07-21 |