| NPI | 1205285814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010826) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5601010826) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2023-12-04 |