| NPI | 1740620517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX S2229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 06302) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2020-11-09 |