| NPI | 1376927707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX S0898) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107943) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2020-10-27 |