| NPI | 1710244397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: KY 53968) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD457774) |
| 207N00000X Dermatology (Licence: KY 53968) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-03-22 |