| NPI | 1811159387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A138610) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP01393) |
| 207N00000X Dermatology (Licence: FL ME119347) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: MA 244334) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2025-10-03 |