| NPI | 1861424129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX M9055) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OR MD25764) |
| 207ND0900X Dermatology, Dermatopathology (Licence: TX M9055) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX M9055) | |
| 207N00000X Dermatology (Licence: TX M9055) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2009-12-11 |