| NPI | 1922113885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA16478) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA PA16478) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA PA16478) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |