| NPI | 1629456504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OK 31512) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 31512) |
| 207L00000X Anesthesiology (Licence: MN 60860) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 60860) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2022-04-29 |