| NPI | 1336679067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 69029) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214271) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-02-07 |