| NPI | 1750648366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T2796) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: ND 13856) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-08-05 |