| NPI | 1770773061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 7915314-1204) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: UT 7915314-1204) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2025-01-02 |