| NPI | 1114450962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10016) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ AP10016) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2020-01-17 |