| NPI | 1487001483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R5542) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX R5542) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX R5542) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2020-08-24 |