NPI | 1295791408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 003750) |
Additional Taxonomies | 207N00000X Dermatology (Licence: GA 003750) |
207NS0135X Dermatology, Procedural Dermatology (Licence: GA 003750) | |
207NP0225X Dermatology, Pediatric Dermatology (Licence: GA 003750) | |
Enumeration Date | 2006-04-25 |
Last Update Date | 2012-02-01 |