NPI | 1962123034 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016933) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 5016933) |
363L00000X Nurse Practitioner (Licence: NC 5016933) | |
Enumeration Date | 2022-09-07 |
Last Update Date | 2024-07-19 |