| NPI | 1164863056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 0010-04366) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04366) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2021-12-10 |