| NPI | 1104944891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 46742) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301081666) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2024-09-20 |