| NPI | 1942428024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX N9307) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX N9307) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-07-26 |