| NPI | 1912358490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 32640) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NE 32640) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NE 32640) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NE 32640) | |
| 207R00000X Internal Medicine (Licence: NE 7797) | |
| 207N00000X Dermatology (Licence: MN 62694) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2025-11-21 |