| NPI | 1639657521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 60898) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA AP60897308) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2024-04-25 |