| NPI | 1275249757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 12617) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 143705) |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2024-03-12 |