| NPI | 1003012618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OR 28421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR 390200000X) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2011-10-13 |