| NPI | 1912084617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2010-01166) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2010-01166) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2010-01166) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-01-15 |