| NPI | 1700516465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL23-0033) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: SC LL88202) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-05-25 |