| NPI | 1205071297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053747) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA MA053747) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2023-07-19 |