| NPI | 1629892583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN11036419) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL APRN11036419) |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-11-08 |