| NPI | 1013944024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2006010979) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2006010979) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-07-05 |