| NPI | 1578235453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015119) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5015119) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 5015119) | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2023-02-03 |