| NPI | 1730899352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12831) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: NC 0010-12831) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2023-05-15 |