| NPI | 1043741614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD.MD.70014463) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A158558) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A158558) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2025-07-28 |