| NPI | 1740787183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111025) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 9111025) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-06-16 |