NPI | 1578073128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: MA RN285354) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01710) |
Enumeration Date | 2017-10-10 |
Last Update Date | 2020-06-30 |