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 |