| NPI | 1417291675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA21989) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA PA21989) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CA PA21989) | |
| Enumeration Date | 2012-11-11 |
| Last Update Date | 2025-06-05 |