| NPI | 1205804085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 52145) |
| Additional Taxonomies | 2084N0600X (Licence: MA 52145) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MA 52145) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-06-05 |