| NPI | 1003067786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104609) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL PA9104609) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2019-02-05 |