| NPI | 1356122634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL aprn11029119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11029119) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2023-11-15 |