| NPI | 1093229379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2306581) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA RN2306581) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MA RN2306581) | |
| Enumeration Date | 2017-11-25 |
| Last Update Date | 2017-11-25 |