| NPI | 1346620549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CO B2668) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: CO B2668) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-02 |