NPI | 1255974374 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: MD R251160) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R251160) |
Enumeration Date | 2019-10-21 |
Last Update Date | 2024-07-08 |