| NPI | 1013676162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4704348623) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704348623) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2022-04-14 |