| NPI | 1871571794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 77912) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA 33061) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: IA 33061) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2024-09-27 |