| NPI | 1487159596 |
|---|---|
| Former Name | KATELYN MARIKO UPDYKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2022-02027) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-10-29 |