| NPI | 1376962175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX S7586) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301115104) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2022-11-07 |