NPI | 1043778731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018263) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 209018263) |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2019-03-12 |
Last Update Date | 2023-07-26 |