| NPI | 1124678511 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX 143100) | 
| Additional Taxonomies | 208VP0000X (Licence: TX 143100) | 
| Enumeration Date | 2019-09-17 | 
| Last Update Date | 2025-10-07 |