| NPI | 1154485977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: 1073873) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 0010-02314) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2015-07-15 |