| NPI | 1710098413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN159128) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 7937) |
| 207N00000X Dermatology (Licence: TN APN0000007937) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-12-02 |