| NPI | 1316699671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 028184) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 028184) |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2023-11-03 |