| NPI | 1144410796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 203313) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA 203313) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: LA 203313) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2022-12-09 |