| NPI | 1972917524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 304929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT206809) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-04-15 |