| NPI | 1760866974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP9575) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: AZ AP9575) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2022-01-14 |