| NPI | 1871579086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX L1210) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L1210) |
| 207Q00000X Family Medicine (Licence: WI 48023-020) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2021-02-24 |