| NPI | 1265495535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0726) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 9503) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2010-01-22 |