| NPI | 1316327000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2019-01121) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 264191) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2021-02-16 |