| NPI | 1902805740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CT 040703) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 040703) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CT 040703) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2024-01-10 |