| NPI | 1588927354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MB09882600) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5101020085) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101020085) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2024-04-23 |