| NPI | 1649590910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A130962) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA 1053220) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197487) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2024-12-03 |