| NPI | 1689986507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A126933) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A126933) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP2-0036384) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-02-04 |