| NPI | 1295963536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2017041408) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NE 25909) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2021-02-08 |