| NPI | 1861475956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX J4083) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J4083) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-03-30 |