NPI | 1881222388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 1024156) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MA 1024156) |
Enumeration Date | 2020-03-30 |
Last Update Date | 2025-07-21 |