| NPI | 1790444768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 06211525) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX 1790444768) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2025-09-16 |