| NPI | 1700312352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.149075) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY 57162) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-09-11 |