| NPI | 1811345093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MT 91884) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5101023390) |
| 208D00000X General Practice (Licence: FL UO4915) | |
| Enumeration Date | 2016-05-29 |
| Last Update Date | 2021-12-01 |