| NPI | 1871708651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA003169L) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MA003169L) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-03-31 |