| NPI | 1790103968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 008004) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: AZ 008004) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2019-09-12 |