| NPI | 1134652407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61378865) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301505509) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-04-04 |