| NPI | 1639565005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MT 91095) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA ML60563945) |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2020-11-10 |