| NPI | 1972523207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303384) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY F303384) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2016-05-02 |