| NPI | 1376506972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 216379) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 216379) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2007-07-28 |