| NPI | 1770775249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MN 52522) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 52522) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MN 52522) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2016-06-06 |