| NPI | 1093370074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101281508) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 68570) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2024-05-21 |