| NPI | 1972992634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D90864) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD H-000-048-454-080) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2021-07-16 |