| NPI | 1578100384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: KY 3013345) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: KY 3013345) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3013345) | |
| Enumeration Date | 2019-12-01 |
| Last Update Date | 2022-11-17 |