| NPI | 1740742592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 61591814) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 312306) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-11-12 |