| NPI | 1740282508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 0094071) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 009407-1) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2019-03-15 |