| NPI | 1659768497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD467053) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: PA MT209277) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2019-07-12 |