| NPI | 1619062171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 200426) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 200426) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-03-19 |