| NPI | 1114188323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 0010-09540) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09540) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2021-12-14 |