| NPI | 1275541161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AZ 4618) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA PA10004171) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2023-03-30 |