| NPI | 1205019940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 48870) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 129558) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2016-03-22 |