| NPI | 1174525893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP001704C) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA SP001704C) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2023-03-27 |