| NPI | 1083015689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 209017899) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017899) |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209.017899) | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2021-03-25 |