| NPI | 1205330198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9110762) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 9110762) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2020-01-30 |