| NPI | 1831730514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 95101423) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95012840) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2024-11-04 |