| NPI | 1275304248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033992) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 033992) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2025-08-01 |