NPI | 1982231445 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A188970) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA A188970) |
Enumeration Date | 2020-03-25 |
Last Update Date | 2025-08-22 |