| NPI | 1245995992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11016040) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL Aprn11016040) |
| 207R00000X Internal Medicine (Licence: FL APRN11016040) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL APRN11016040) | |
| Enumeration Date | 2021-11-07 |
| Last Update Date | 2024-01-26 |