| NPI | 1558314963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL PA3672) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA3672) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2011-02-17 |