| NPI | 1003250663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA AP60329890) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60329890) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2021-11-10 |