| NPI | 1861756538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 66181-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301101448) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301101448) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WI 66181-20) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-10-28 |