NPI | 1801438148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006937) |
Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0110006937) |
Enumeration Date | 2019-10-08 |
Last Update Date | 2024-02-02 |