| NPI | 1730596875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9114207) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD C0005406) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2023-04-19 |