| NPI | 1023302965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD455398) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT199663) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2017-02-07 |