| NPI | 1518438332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704264238) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2021-09-01 |