| NPI | 1255757134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 338629) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 338629) |
| Enumeration Date | 2014-03-15 |
| Last Update Date | 2014-03-17 |