| NPI | 1730499294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: MI 4301097754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301097754) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2020-06-15 |