| NPI | 1871832881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 13629) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 20A13629) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2025-01-10 |