| NPI | 1093179533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 282418) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 270811) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211659) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2020-07-04 |