| NPI | 1740791763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017736) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA SP017736) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2022-09-15 |