NPI | 1417472887 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016242) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 209016242) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2020-07-27 |