| NPI | 1619111473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 66247) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 254121) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 66247) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2022-08-18 |