| NPI | 1912292699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: HI MD18588) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: HI MD18588) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: OR MD172255) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2017-05-02 |