NPI | 1255954244 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013348) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5013348) |
Enumeration Date | 2020-05-25 |
Last Update Date | 2023-11-13 |