| NPI | 1871578344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX U1353) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 30913) |
| 207N00000X Dermatology (Licence: WI 67706) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-03-07 |