| NPI | 1295360915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2452) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NE 2452) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-04-27 |