| NPI | 1245591783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 142779) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX 573390) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2021-11-30 |