| NPI | 1922494095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 297671) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: NC 02455) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-10-04 |