| NPI | 1194844324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301087887) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087887) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2012-09-06 |