| NPI | 1174626840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO R5G74) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: MO R5G74) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-06-19 |