NPI | 1609219617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: WA MD61417950) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259494) |
208VP0000X Pain Medicine, Pain Medicine (Licence: NH 18173) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 259494) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-09 |
Last Update Date | 2023-04-04 |