| NPI | 1700090024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 25720) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE 5447) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2016-02-26 |