| NPI | 1306312277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011133) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 5011133) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2021-03-31 |