| NPI | 1285213900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114039) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL PA9114039) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2022-01-11 |