NPI | 1144970708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9380) |
Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 9380) |
Enumeration Date | 2022-03-26 |
Last Update Date | 2022-11-01 |