| NPI | 1801215751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AR E-11594) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AR E-11594) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-09-05 |