| NPI | 1417047242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01210) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WV 01210) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: WV 01210) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-02-24 |