| NPI | 1275607855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 00332) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 00332) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-08-10 |