| NPI | 1275663593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200200805) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: NC 200200805) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2025-08-05 |