| NPI | 1255974374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R251160) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: MD R251160) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2023-04-06 |