| NPI | 1326654674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 243397) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 243397) | 
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 243397) | |
| Enumeration Date | 2020-09-22 | 
| Last Update Date | 2021-10-25 |