| NPI | 1679801500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0102203481) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.003160) |
| 207N00000X Dermatology (Licence: MI 5101018951) | |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2013-11-11 |