| NPI | 1376954883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: NY 332485) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: MN 64509) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2025-03-26 |