| NPI | 1154717544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2019-00260) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 8296) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 8296) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 210171) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2019-02-27 |