| NPI | 1265015077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA59458) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA59458) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2025-04-16 |