| NPI | 1598501504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00812) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MS PA00812) |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2025-04-10 |