| NPI | 1801983739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35145277) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301068144) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301068144) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35145277) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-05-10 |