| NPI | 1043745474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.142754) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 67868) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2025-01-21 |