| NPI | 1699247262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111664) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL PA9111664) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2023-11-15 |