| NPI | 1639478464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: GA 79976) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 016521) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2022-05-09 |