| NPI | 1912638859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA61274) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA PA61274) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2024-09-12 |