| NPI | 1790197200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D0094851) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101265841) |
| 207N00000X Dermatology (Licence: MD D0094851) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2024-02-21 |