| NPI | 1467457739 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005161) | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0810005161) | 
| Enumeration Date | 2005-06-14 | 
| Last Update Date | 2023-08-10 |