| NPI | 1770802258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY n/a) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY na) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NY n/a) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NY n/a) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY n/a) | |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2018-03-22 |