| NPI | 1801393160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MD D0097632) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 75055) |
| 207N00000X Dermatology (Licence: NY 321191-01) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2023-07-20 |