| NPI | 1821795436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NC 0010-13286) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13286) |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2024-12-03 |