| NPI | 1043444219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 45932) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME107728) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2022-09-20 |