NPI | 1922113885 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA PA16478) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA16478) |
207NS0135X Dermatology, Procedural Dermatology (Licence: CA PA16478) | |
Enumeration Date | 2006-08-20 |
Last Update Date | 2025-09-11 |