NPI | 1902280308 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 264585) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MA 264585) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2020-10-05 |