| NPI | 1912239658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 4183) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003533) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2018-03-17 |