| NPI | 1508939307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 24849.0904) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: WY 24849.0904) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-07-26 |