| NPI | 1104802834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 6345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 6345) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PR 6345) | |
| 209800000X Legal Medicine (Licence: PR 6345) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-07-15 |