| NPI | 1801419684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY F345900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F345900-01) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2022-02-24 |