NPI | 1780150425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD C06976) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006976) |
Enumeration Date | 2018-10-21 |
Last Update Date | 2023-09-20 |