| NPI | 1962580050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CO DR.0070724) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A82504) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 261458) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-05-02 |