| NPI | 1003342072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A172297) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI MDR###) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-05-24 |