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 |