| NPI | 1346732336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 53-78212-121) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 53-78212-121) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-05 |