| NPI | 1679543078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101052700) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: VA 0101052700) |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101052700) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101052700) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2012-06-01 |