| NPI | 1184265902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 026907) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL 1184265902) |
| 363AM0700X Physician Assistant, Medical (Licence: FL 9112634) | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2023-05-22 |