| NPI | 1013203769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116040215) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CO DR0055818) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2025-06-20 |