NPI | 1992717490 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35-098349) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2006018686) |
Enumeration Date | 2006-08-13 |
Last Update Date | 2021-08-23 |