| NPI | 1720332851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA14124) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 10667) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2023-06-04 |