| NPI | 1992717490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 0000057867) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2006018686) |
| 207N00000X Dermatology (Licence: TN 0000057867) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35-098349) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2025-05-16 |