| NPI | 1922589548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 56033) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA PA56033) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2025-08-12 |