| NPI | 1023639853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 24583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 24583) |
| 363L00000X Nurse Practitioner (Licence: SC 24583) | |
| 163W00000X Registered Nurse (Licence: SC 234927) | |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2024-05-03 |