| NPI | 1114655214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2024009420) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2024009420) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2025-01-17 |