| NPI | 1730341736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA08545300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NJ 25MA08545300) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2017-11-15 |