NPI | 1295166601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006890) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5601006890) |
Enumeration Date | 2013-12-11 |
Last Update Date | 2022-04-14 |