| NPI | 1336776525 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 83730)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351047329)  | 
| 207N00000X Dermatology (Licence: MI 4351047329)  | |
| 207R00000X Internal Medicine (Licence: NC 260655)  | |
| Enumeration Date | 2020-03-26 | 
| Last Update Date | 2024-08-28 |