| NPI | 1124256284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA C143388) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 254656) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 241413) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2016-11-08 |