| NPI | 1770176182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5014099) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014099) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-12-14 |