| NPI | 1003076928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: PA MD472638) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY AH1160439) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 259765) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2025-08-09 |