| NPI | 1508938481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000576) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MP00136500) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2010-08-31 |