| NPI | 1437498474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: NE 1718) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2022-11-11 |