| NPI | 1255959417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 0000029524) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 0000029524) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2024-02-26 |