| NPI | 1851882716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MO 2023024448) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA R-11179) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MN 71536) | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2023-09-19 |