| NPI | 1003121609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL PA9108883) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA 06798) |
| 363A00000X Physician Assistant (Licence: FL PA9108883) | |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2023-04-24 |