| NPI | 1649501545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA PA6249) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0753) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MA PA6249) | |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2020-09-27 |