| NPI | 1992816664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 5010)  | 
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 5010)  | 
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2020-01-30 |