NPI | 1497104822 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CT 66236) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267424) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-06-07 |
Last Update Date | 2020-07-01 |