| NPI | 1164534699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04718) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX PA04718) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-05-11 |