| NPI | 1689166126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA RN2315989) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2315989) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2020-11-03 |