| NPI | 1992912836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704156996) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4704156996) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2024-07-30 |