| NPI | 1720320435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 56095) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 292293) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-03-30 |