NPI | 1265043483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114830) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL PA9114830) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-08-11 |
Last Update Date | 2025-08-12 |