| NPI | 1083802599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA18187) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA18187) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2013-03-25 |