| NPI | 1710338090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601007767) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5601007767) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-02-27 |