| NPI | 1851471676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 112044) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 112044) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2023-07-05 |