| NPI | 1528228319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101257007) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017371) |
| 207N00000X Dermatology (Licence: MA 244641) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2024-06-24 |