| NPI | 1053819326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 309667) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2313980) |
| 363L00000X Nurse Practitioner (Licence: MA RN2313980) | |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2021-07-26 |