| NPI | 1518957133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SD 0539) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SD 0539) |
| 363A00000X Physician Assistant (Licence: SD 0539) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2011-01-10 |