NPI | 1447628714 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH COA.1779-NP) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.17779-NP) |
Enumeration Date | 2015-09-03 |
Last Update Date | 2021-06-02 |