| NPI | 1740983816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN2276061) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA RN2276061) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2025-05-08 |