| NPI | 1538140959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MA003105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA003105) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2023-09-28 |