| NPI | 1619441730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704288891) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704288891) |
| 207N00000X Dermatology (Licence: MI 4704288891) | |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2024-05-02 |