| NPI | 1619435724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011554) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5011554) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5011554) | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2023-08-21 |