NPI | 1669945259 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08705) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 0010-08705) |
Enumeration Date | 2019-01-07 |
Last Update Date | 2019-01-07 |