| NPI | 1831734813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 1175) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: NM 1175) |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |