| NPI | 1043443880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA SP016308) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP016308) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2019-09-12 |