| NPI | 1720548167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OH 35.151355) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 59416) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-09-25 |