| NPI | 1669146486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008720) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0110-008720) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2026-08-05 |