| NPI | 1487113270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: IL 036.168346) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301509331) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351045539) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-07-07 |