| NPI | 1528453701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A146480)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2015-04-03 | 
| Last Update Date | 2021-12-07 |