| NPI | 1770997694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 332779) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D0085760) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT207505) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2024-11-01 |