NPI | 1912519299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA58371) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA58371) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2025-04-16 |