| NPI | 1255858247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA AP60791082) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60791082) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2020-02-26 |