| NPI | 1821477811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2020-02972) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL38128) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2023-06-09 |