| NPI | 1366054629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12104) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 0010-12104) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2024-06-25 |