| NPI | 1821443524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 70219) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: UT 10929348-1204) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: UT 10929348-1204) | |
| Enumeration Date | 2016-05-01 |
| Last Update Date | 2022-05-25 |