| NPI | 1518940790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: NC 9300608) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NC 9300608) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NC 9300608) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-04-20 |