| NPI | 1689846826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV 1363) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53417) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NV PA1363) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2019-03-26 |