NPI | 1013260421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: OH COA.14058-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH F0912131) |
Enumeration Date | 2012-10-23 |
Last Update Date | 2015-07-10 |