| NPI | 1497016596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 283935) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT202086) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT202086) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2017-01-06 |