| NPI | 1700938032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA18452) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA18452) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA PA18452) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA PA18452) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA18452) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2015-07-27 |