| NPI | 1184679300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 17490) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 17490) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-03-04 |