| NPI | 1942543780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R2011) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 278814) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2023-01-17 |