| 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 |