| NPI | 1568136588 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD F07210805)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD F07210805)  | 
| 207N00000X Dermatology (Licence: VA 0024190683)  | |
| 207N00000X Dermatology (Licence: DC NP1057201)  | |
| Enumeration Date | 2021-08-03 | 
| Last Update Date | 2025-07-31 |