| NPI | 1649470493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2015-00856) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI LP01457) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA mt191132) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2015-10-28 |