| NPI | 1023395928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX T9346) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178007242) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2023-04-10 |