| NPI | 1831355627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2015-01291) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA MD-44318) |
| 207N00000X Dermatology (Licence: TN MD48619) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IA MD-44318) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301092370) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2023-04-03 |