| NPI | 1578197588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 345211) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: NY 345211) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 345211) | |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2020-02-28 |