| NPI | 1295988640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: TX PA09858) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX AP09858) |
| 363A00000X Physician Assistant (Licence: TX PA09858) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2022-09-20 |