| NPI | 1194163063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC MD85178) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D83443) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: Type 1 NPI number) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-09-27 |