| NPI | 1922605278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 247922) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 247922) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-29 |