| NPI | 1710375001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IN 71005410A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71005410A) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2020-07-29 |