| NPI | 1972644532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3540) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 3540) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2023-12-08 |