| NPI | 1356861975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA A125067) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 8205) |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2023-09-26 |