| NPI | 1326750514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5017752) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: NC 5017752) |
| 363L00000X Nurse Practitioner (Licence: NC 5017752) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-07-19 |