| NPI | 1609508746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2022024350) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2022024350) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2023-07-05 |