| NPI | 1013479062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 202500918) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: MO 2021009119) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-04-16 |