| 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 |