| NPI | 1518929116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9104105) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 103405) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2007-08-09 |