| NPI | 1679567150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 032749) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 03279) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 032749) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2022-10-23 |