| NPI | 1174188478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0019016556) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019016556) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2021-05-25 |