| NPI | 1407218670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 282375) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT210602) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-04-13 |