| NPI | 1790888584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CT 040694) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 040694) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-03-06 |