| NPI | 1861716292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ 25MB09749500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 252229) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 252229) | |
| 363A00000X Physician Assistant (Licence: NY 008820-1) | |
| Enumeration Date | 2010-03-14 |
| Last Update Date | 2015-08-28 |