| NPI | 1669081204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 21341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 21341) |
| 364SW0102X Clinical Nurse Specialist, Women's Health (Licence: CA 21341) | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |