| NPI | 1861927964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA11153300) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 309176) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2021-09-08 |