| NPI | 1477711422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 247832) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 247832) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 247832) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2014-10-29 |