| NPI | 1194461202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX W7969) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.253465) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2026-08-28 |