| NPI | 1508216458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0064906) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL 0006342) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2024-03-11 |