| NPI | 1164949053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006577) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD C0006577) |
| 363A00000X Physician Assistant (Licence: DC PA031380) | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2024-01-15 |