| NPI | 1568027159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 67695) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG193642) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2024-01-19 |