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 |