| NPI | 1902881659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: GA 035943) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: GA 35943) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-19 |