| NPI | 1114915402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX E9484) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX E9484) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2012-02-22 |