| NPI | 1467838979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2949) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MA057573) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2022-10-31 |