| NPI | 1598104176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME155699) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2017-01441) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT203682) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2022-09-21 |