| NPI | 1669563920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 43695) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN MD43695) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ MA69168) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-04-06 |