| NPI | 1053553131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WV 25886) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: CA A123744) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2015-01-23 |