NPI | 1992069876 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 57584) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TN 57584) |
Enumeration Date | 2012-06-26 |
Last Update Date | 2020-11-03 |