| NPI | 1982268504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ R77470) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 1027106) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2026-05-21 |