| NPI | 1205417367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-11150) |
| 208000000X Pediatrics (Licence: MO 2022024139) | |
| 207N00000X Dermatology (Licence: NC RTL23-0032) | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2023-04-27 |