| NPI | 1720490519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.133541) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03149) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2019-01-03 |