| NPI | 1679075840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD R179185) |
| 207N00000X Dermatology (Licence: MD R179185) | |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2022-07-27 |