| NPI | 1912494188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR PG188434) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS18824) |
| 207N00000X Dermatology (Licence: FL UO6375) | |
| 207N00000X Dermatology (Licence: FL OS18824) | |
| 207N00000X Dermatology (Licence: CA 24681) | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2026-05-07 |