| NPI | 1164256285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F311987) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY F311987) |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2024-08-30 |