| NPI | 1538767579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: TX AP144269) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: TX AP144269) |
| 363L00000X Nurse Practitioner (Licence: TX AP144269) | |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2022-08-30 |