NPI | 1982047924 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: MO 2017012833) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2017012833) |
Enumeration Date | 2013-04-09 |
Last Update Date | 2024-04-05 |