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 |