| NPI | 1184323586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023010764) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2023010764) |
| Enumeration Date | 2023-02-24 |
| Last Update Date | 2024-05-21 |