| NPI | 1811121247 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q6019) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB08946900) | 
| 207L00000X Anesthesiology (Licence: NY 257067) | |
| 207L00000X Anesthesiology (Licence: AZ 007136) | |
| 207L00000X Anesthesiology (Licence: CA 20A16304) | |
| 208VP0000X (Licence: NJ 25MB08946900) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 257067) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MB08946900) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-13 | 
| Last Update Date | 2022-09-07 |