| NPI | 1811091069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G66971) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G66971) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA G66971) | |
| Enumeration Date | 2006-09-09 |
| Last Update Date | 2012-08-02 |