| NPI | 1881929909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35.122915) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.016124) |
| 207N00000X Dermatology (Licence: OH 35.122915) | |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2014-12-31 |