| NPI | 1619601671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL PA9115776) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115776) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-07-12 |