NPI | 1962674184 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CT 046352) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CT 046352) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 253189) | |
207N00000X Dermatology (Licence: NY 253189) | |
Enumeration Date | 2008-03-27 |
Last Update Date | 2020-09-28 |