| NPI | 1104434745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL 11007936) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007936) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-11-12 |