| NPI | 1356834113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA A099502) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA A099502) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A099502) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-08-05 |