| NPI | 1770108193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2026-01913) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207N00000X Dermatology (Licence: AZ 71856) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 71856) | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2026-06-22 |