| NPI | 1821063678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX M6749) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX M6749) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX M6749) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-09-12 |