| NPI | 1144062316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 9119133) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-10-29 |