| NPI | 1568105898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA 95019593) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95019593) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2024-05-07 |