| NPI | 1528379153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005771) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5601005771) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2024-07-31 |