NPI | 1417130147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA PA19475) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA19475) |
Enumeration Date | 2007-12-17 |
Last Update Date | 2021-10-25 |