| NPI | 1790897957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP00925) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R41289) |
| 207N00000X Dermatology (Licence: NM R41289) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-02-16 |