| NPI | 1811289259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005922) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5601005922) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2018-08-08 |