| NPI | 1801438148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006937) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0110006937) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2026-09-30 |