| NPI | 1003325648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110667) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL PA9110667) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-07-21 |