| NPI | 1649860487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5014009) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5014009) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5014009) | |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2022-11-03 |