| NPI | 1801234174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2019020870) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036158005) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036158005) | |
| 207R00000X Internal Medicine (Licence: MO 2019020870) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2021-09-23 |