| NPI | 1861839383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 56347) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: CT AY2629155) | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2017-04-30 |