NPI | 1730311507 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA 131152) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 2648654) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA 131152) | |
207R00000X Internal Medicine (Licence: IL 125.056776) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-08-12 |
Last Update Date | 2018-01-17 |