| NPI | 1164524161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 333129) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 333129) |
| 363L00000X Nurse Practitioner (Licence: NJ 26NN10186900) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-10-30 |