| NPI | 1508252198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 282801) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: CT 62959) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2020-06-29 |