| NPI | 1972816890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 34964) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: AL 34964) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2017-05-09 |