| NPI | 1487899365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-773) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: ID M7247) |
| 363A00000X Physician Assistant (Licence: ID PA773) | |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2020-01-27 |