| NPI | 1417954892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: PA MA050831) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: PA MA050831) |
| 363AM0700X Physician Assistant Medical (Licence: PA MA050831) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2019-04-22 |