NPI | 1124431143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A154173) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A154173) |
208000000X Pediatrics (Licence: PA MT206697) | |
Enumeration Date | 2014-06-06 |
Last Update Date | 2022-08-09 |