| NPI | 1003907478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN101568) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: GA RN101568) |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: GA RN101568) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: GA RN101568) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2021-03-31 |