| NPI | 1033679535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 105445) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 105445) |
| 207N00000X Dermatology (Licence: MI 4301511868) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-10-14 |