| NPI | 1770535304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G61351) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G61351) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-06-13 |