| NPI | 1376738633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: PA OS015844) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS015844) |
| 208VP0000X (Licence: FL OS11638) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2021-05-07 |