| NPI | 1316145717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 243603) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 246303-1) | 
| Enumeration Date | 2007-07-06 | 
| Last Update Date | 2018-03-28 |