| NPI | 1134387657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 265149) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 103698) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207N00000X Dermatology (Licence: NJ 25MA09134000) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-03-22 |