| NPI | 1063555639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: OH 35.099799) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2008002472) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: KY 43973) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-01-29 |