NPI | 1003076928 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: PA MD472638) |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 259765) |
Enumeration Date | 2008-06-13 |
Last Update Date | 2021-03-22 |