| NPI | 1396060794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX P3746) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: CA 20A12095) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2017-01-17 |