| NPI | 1417272469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL 115694) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: FL ME115694) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2021-07-20 |