| NPI | 1881778942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 56165) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 900114) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-04-08 |