| NPI | 1811148224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A109338) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 267800) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: student) | |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2022-08-23 |