| NPI | 1407692791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110010179) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0110010179) |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-08-30 |