| NPI | 1568868263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA PA52517) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC 031088) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2019-06-11 |