| NPI | 1710453733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX AP139282) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX AP139282) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 878909) | |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2022-09-19 |