| NPI | 1255981338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003347) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 11003347) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-09-23 |