| NPI | 1851658355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID O-1048) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX S6433) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: TX S6433) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: ID O-1048) | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2023-02-13 |