| NPI | 1780650036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP7482) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 45627) |
| 363L00000X Nurse Practitioner (Licence: KS 45627) | |
| 363L00000X Nurse Practitioner (Licence: CA 22657) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2022-10-06 |