NPI | 1982784823 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NH 17581) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MA 215758) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MA 215758) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: MA 215758) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2021-02-15 |