| NPI | 1083251250 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 825338) | 
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 825338) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NV 825338) | |
| Enumeration Date | 2019-12-05 | 
| Last Update Date | 2021-05-02 |