| NPI | 1841685658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MT 113618) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 287108) |
| 207N00000X Dermatology (Licence: WA MD60769542) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: WA MD60769542) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-07-26 |