| NPI | 1629693536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309874) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 309874) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 702716-1) | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-10-14 |