| NPI | 1508275678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2584) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 2584) |
| Enumeration Date | 2014-08-03 |
| Last Update Date | 2017-10-10 |