| NPI | 1861803330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61422430) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD61422430) | |
| Enumeration Date | 2014-05-18 |
| Last Update Date | 2024-01-22 |