| NPI | 1508834128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 32172) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: KY 32172) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2021-07-19 |