NPI | 1881152775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60561) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA60561) |
Enumeration Date | 2019-03-09 |
Last Update Date | 2024-02-12 |