| NPI | 1992184816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 278444) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA L-263604) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2019-05-22 |