| NPI | 1851598205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101249416) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME102686) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019250) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2011-08-10 |