| NPI | 1841289519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME 85461) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME85461) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 204298) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2024-06-03 |