| NPI | 1679112437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5012787) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012787) |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2021-12-14 |