| NPI | 1245619998 |
|---|---|
| Former Name | ELIZABETH MICHELLE BURGESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 58817) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2019-06-26 |