| NPI | 1982028122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51434) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 51434) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2023-08-01 |