Cardiologist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Chiropractor providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Dentist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Dermatologist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Family Physician providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
OB-GYN providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Ophthalmologist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Orthopedic Surgeon providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Pediatrician providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Physical Therapist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Podiatrist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Psychiatrist providers include doctors, nurses, nurse practitioners, and physician assistants. They often maintain long-term relationships with you and advise and treat you on a range of health related issues.
Union Anesthesia Associates provides high-quality pain management to people with acute, chronic, and severe pain. At their offices in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey, the board-certified anesthesiologists and pain management specialists work closely with each person to find and treat the pain’s source rather than just masking symptoms.
At each office, you will receive a thorough evaluation, clinical exam, and review of diagnostic tests including MRIs to diagnose the root cause of your neck, spine, back pain, and any other ailments including headaches, nerve pain, and joint pain. The providers also offer comprehensive evaluations and treatments for all headaches, including cluster headaches and chronic migraines.
The Union Anesthesia Associates team has extensive experience managing acute and chronic pain conditions such as neck and back pain, herniated discs, sciatica, radiculopathy, neuropathy, spinal stenosis, arthritis, complex regional pain syndrome, joint pain, and nerve pain. They use medication management, anti-inflammatories, muscle relaxants, injectable anesthetics, and interventional pain management including epidural steroid injections, facet joint injections, radiofrequency ablation, nerve blocks, spinal cord stimulation, and minimally invasive surgery.
The highly skilled pain management specialists treat pain conditions caused by workplace injuries, motor vehicle accidents, and slip-and-fall events. They also provide personalized care for pain after surgery and complications such as failed back syndrome, postlaminectomy syndrome, adhesions, and phantom limb syndrome.
Minimally invasive spine surgery is available for chronic back and neck pain. Union Anesthesia Associates offers specialized procedures such as endoscopic surgery, and rhizotomy to ease the chronic pain or injuries associated with trauma and degenerative spine disorders. Spinal cord stimulation trials and permanent implantations are also available.
The Union Anesthesia Associates staff maintains a friendly, welcoming environment and offers flexible appointment times. The experienced physicians collaborate on all aspects of patient care to ensure a high level of pain management and the best treatment outcomes.
Call the Union Aesthetics Associates office near you today to schedule a consultation or book an appointment online.
Philip M. Rojo, MLP-NP, is a highly skilled nurse practitioner passionate about delivering customized care. Through his work at Union Spine and Pain Management, which has offices in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey, Philip helps patients feel more comfortable as they progress in treatment.
A lifelong learner, Philip earned a Bachelor of Science in nursing from Rutgers, The State University of New Jersey, in New Brunswick. He remains at Rutgers to complete a Master of Science in nursing, focusing on adult and geriatric care.
Philip is trained in basic life support and advanced cardiac life support. He is also certified as an adult/gerontology acute care nurse practitioner.
Philip’s professional experience includes working in emergency room settings and managing patient care across various crisis and trauma needs. He also brings experience in managing patient care after surgical interventions, in addition to treating numerous acute and chronic musculoskeletal pain disorders.
Philip enjoys working one-on-one with those in his care, getting to know them and their unique health needs. He finds his work deeply rewarding, especially when patients overcome significant challenges in pain management.
Marlyn Alvarado, FNP-C, is a board-certified family nurse practitioner at Union Spine and Pain Management. The practice has locations in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey. Proficient in English and Spanish, Marlyn brings a wealth of experience delivering comprehensive care to diverse populations of all ages.
Marlyn embarked on her nursing journey at New Jersey City University in Jersey City, where she earned her nursing degree. During this time, she served as a surgical nurse at Jersey City Medical Center in Jersey City, New Jersey, where she cared for patients undergoing chemotherapy, dialysis, and surgery.
Continuing her work at Jersey City Medical Center, Marlyn served in pivotal roles as a transition discharge nurse and maternal child health nurse. Here, she managed patients with high-risk pregnancies, substance use disorder, and teen pregnancy, demonstrating her versatility in addressing complex healthcare needs.
She also served as a case manager at United Healthcare in West New York, New Jersey, and later as a wellness coach/chronic condition manager at Premise Health. These roles further developed her understanding of holistic healthcare management and patient support.
Passionate about advancing her nursing practice, Marlyn pursued her Master of Science in nursing at Spring Arbor University in Spring Arbor, Michigan. This led to her family nurse practitioner certification from the American Academy of Nurse Practitioners.
Marlyn holds additional certifications in neonatal resuscitation from the American Academy of Pediatrics and advanced cardiac life support from the American Heart Association.
In her role at Union Spine and Pain Management, Marlyn enjoys collaborating with the team, ensuring that she meets the diverse needs of her patients.
Wayne Fleischhacker, DO, DABA, DABPM, DAAPM, is the director of Union Spine and Pain Management with offices in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey. He has vast experience in anesthesiology and pain management, including minimally invasive pain management procedures and surgery.
Dr. Fleischhacker began his education at Rochester Institute of Technology in Rochester, New York, receiving his bachelor’s degree in biology. He later achieved his medical degree at the New York College of Osteopathic Medicine in Old Westbury.
Shortly after, he completed a rotating internship at Massapequa General Hospital in Seaford, New York, followed by anesthesiology and pain management training at Temple University Hospital in Philadelphia, Pennsylvania.
Dr. Fleischhacker is on staff at multiple hospitals and surgery centers in New Jersey.
He also served as the attending anesthesiologist and chairman of the anesthesiology and pain management department at Union Hospital in New Jersey and the Endo-Surgical Center as the director of anesthesiology and pain management.
Established in the medical field, Dr. Fleischhacker is a diplomate of the American Board of Anesthesiology, the American Board of Pain Medicine, the American Academy of Pain Management, and the National Board of Osteopathic Medical Examiners.
He is also a member of the American Society of Anesthesiologists, the New Jersey Society of Anesthesiologists, the American Board of Pain Management, the International Spine Intervention Society, the American Society of Interventional Pain Physicians, and Director of the New Jersey Society of Interventional Pain Physicians.
Dr. Fleischhacker's dedication to patient-centered care and his commitment to enhancing medical knowledge continue to make a profound impact on the lives of countless patients and his team at Union Spine and Pain Management.
“I have met Dr Fleishhaker only 2 times. Office visits are performed by PA and other professionals but not the doctor. I have seen his associate Michelle on several visits but today another associate inquired about my progress since the epidural. I believe that it is important that I meet consistently with Michelle and I explained that. I have had significant improvement with the 2 epidurals, one in September and 2nd in November.”
Dr. Wayne Fleischhacker, DO
Anesthesiologist
40 Route 34 South
Old Bridge, NJ 08857
4.82(98)
Maria Culver, DPT
Physiatrist (Physical Medicine & Rehabilitation) 31.7 mi
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Michael Rizkalla, MD, a skilled physician with double-board certification in sports medicine and physical medicine and rehabilitation, founded Revive Spine and Pain Center in 2017. At the practice’s offices in Marlton, Hamilton Township, East Brunswick and Northfield, New Jersey, he provides a patient-centered approach to treating acute and chronic pain.
He begins each appointment by listening to patients who all too often say that they’ve been everywhere and no one listens to or helps them. After hearing and understanding each person’s unique story and completing a physical exam, Dr. Rizkalla creates a tailored treatment plan using evidence-based treatments drawn from traditional medicine, interventional medicine, physical therapy, and complementary and restorative practices.
Dr. Rizkalla received his medical degree from Ross University School of Medicine in Miramar, Florida, then finished an internship in internal medicine before completing a residency in physical medicine and rehabilitation at Harvard Medical School, Spaulding Rehabilitation Hospital in Cambridge, Massachusetts.
Dr. Rizkalla has a subspecialty in sports medicine, has fellowship training in interventional pain management, and is certified in contemporary medical acupuncture. In addition to diagnosing and treating pain, his clinical interests include spine and joint care, sports medicine, electrodiagnostic and neuromuscular medicine, and nonsurgical orthopedics.
He has extensive training in performing numerous interventional pain procedures and restorative injections, such as platelet-rich plasma (PRP) and bone marrow aspirate cells. Dr. Rizkalla is also proficient in using musculoskeletal ultrasound to diagnose and treat injuries.
Dr. Selorm Takyi joined Revive Spine and Pain Center in 2020. He completed his physiatry residency at JFK Johnson Rehabilitation Institute, offered through the Department of Physical Medicine and Rehabilitation at Rutgers Robert Wood Johnson Medical School. With a passion for teaching, he served as an academic chief resident and graduated residency in 2019. He then completed his fellowship in regenerative orthopedics and musculoskeletal medicine.
Dr. Takyi practices compassionate medicine and was inducted into the Gold Humanism Honor Society in 2014 while attending Rutgers New Jersey Medical School. Specializing in both ultrasound-guided and fluoroscopic-guided techniques to treat pain and sports medicine injuries, he is excited to share his goal of using non-surgical procedures to help restore function and quality of life to his patients. With his training in physiatry, Dr. Takyi enjoys creating comprehensive treatment plans for his patients. In addition to offering interventional spine injections such as epidurals and nerve blocks, he performs platelet-rich plasma (PRP) and micro-fragmented adipose tissue (MFAT) injections to help treat a variety of neuromusculoskeletal conditions. His clinical interests include regenerative medicine, rotator cuff tears, osteoarthritis, ACL injuries, and meniscus tears.
He has co-authored the physical modalities, therapeutic exercise, extended bedrest, and aging effects chapter in the Physical Medicine and Rehabilitation Board Review 4th Edition and an upcoming publication, Atlas of Interventional Orthopedics Procedures chapter on autologous tissue harvesting techniques: bone marrow aspirate and adipose tissue. He is a member of the American Academy of Physical Medicine and Rehabilitation, Interventional Orthobiolgoics Foundation, Spine Intervention Society, and the American Medical Society for Sports Medicine. When not in the office, Dr. Takyi enjoys photography, exercising, and spending time with his family.
Mahmud Ibrahim, MD, at Revive Spine and Pain Center Marlton, Hamilton Township, East Brunswick and Northfield, New Jersey, holds dual board certification in sports medicine and physical medicine and rehabilitation and is fellowship trained in interventional pain management.
When treating patients at Revive Spine and Pain Center, his goal is to restore function, reduce pain, and promote an active, healthy lifestyle using conservative measures whenever possible.
Though Dr. Ibrahim treats pain from any cause, his special clinical interests include musculoskeletal medicine, non-operative spine procedures, orthopedics, sports medicine, electrodiagnostic medicine, and restorative therapy.
In addition to performing the full range of fluoroscopic-guided interventional pain-management procedures, he also uses diagnostic and therapeutic ultrasound. He has extensive skill in minimally invasive procedures such as discectomies and percutaneous tenotomies.
After graduating from the New York University Grossman School of Medicine in New York City, Dr. Ibrahim completed his residency training in physical medicine and rehabilitation at the Icahn School of Medicine at Mount Sinai School (also in New York City). After receiving an Accreditation Council for Graduate Medical Education (ACGME) fellowship, he stayed at Mount Sinai to subspecialize in sports and interventional spine medicine.
Dr. Ibrahim has published several articles on musculoskeletal medicine. He’s also a contributing author in a textbook on how to perform ultrasound-guided injections and the author of a book exploring what causes pain, how to reduce it, and ways to live with persistent pain.
Dr. Ibrahim has provided sideline coverage at football games, captained the medical tents at the New York City marathon, and was a ringside physician for the Golden Gloves of America boxing tournament and professional wrestling.
Michael Rizkalla, MD, a skilled physician with double-board certification in sports medicine and physical medicine and rehabilitation, founded Revive Spine and Pain Center in 2017. At the practice’s offices in Marlton, Hamilton Township, East Brunswick and Northfield, New Jersey, he provides a patient-centered approach to treating acute and chronic pain.
He begins each appointment by listening to patients who all too often say that they’ve been everywhere and no one listens to or helps them. After hearing and understanding each person’s unique story and completing a physical exam, Dr. Rizkalla creates a tailored treatment plan using evidence-based treatments drawn from traditional medicine, interventional medicine, physical therapy, and complementary and restorative practices.
Dr. Rizkalla received his medical degree from Ross University School of Medicine in Miramar, Florida, then finished an internship in internal medicine before completing a residency in physical medicine and rehabilitation at Harvard Medical School, Spaulding Rehabilitation Hospital in Cambridge, Massachusetts.
Dr. Rizkalla has a subspecialty in sports medicine, has fellowship training in interventional pain management, and is certified in contemporary medical acupuncture. In addition to diagnosing and treating pain, his clinical interests include spine and joint care, sports medicine, electrodiagnostic and neuromuscular medicine, and nonsurgical orthopedics.
He has extensive training in performing numerous interventional pain procedures and restorative injections, such as platelet-rich plasma (PRP) and bone marrow aspirate cells. Dr. Rizkalla is also proficient in using musculoskeletal ultrasound to diagnose and treat injuries.
Dr. Selorm Takyi joined Revive Spine and Pain Center in 2020. He completed his physiatry residency at JFK Johnson Rehabilitation Institute, offered through the Department of Physical Medicine and Rehabilitation at Rutgers Robert Wood Johnson Medical School. With a passion for teaching, he served as an academic chief resident and graduated residency in 2019. He then completed his fellowship in regenerative orthopedics and musculoskeletal medicine.
Dr. Takyi practices compassionate medicine and was inducted into the Gold Humanism Honor Society in 2014 while attending Rutgers New Jersey Medical School. Specializing in both ultrasound-guided and fluoroscopic-guided techniques to treat pain and sports medicine injuries, he is excited to share his goal of using non-surgical procedures to help restore function and quality of life to his patients. With his training in physiatry, Dr. Takyi enjoys creating comprehensive treatment plans for his patients. In addition to offering interventional spine injections such as epidurals and nerve blocks, he performs platelet-rich plasma (PRP) and micro-fragmented adipose tissue (MFAT) injections to help treat a variety of neuromusculoskeletal conditions. His clinical interests include regenerative medicine, rotator cuff tears, osteoarthritis, ACL injuries, and meniscus tears.
He has co-authored the physical modalities, therapeutic exercise, extended bedrest, and aging effects chapter in the Physical Medicine and Rehabilitation Board Review 4th Edition and an upcoming publication, Atlas of Interventional Orthopedics Procedures chapter on autologous tissue harvesting techniques: bone marrow aspirate and adipose tissue. He is a member of the American Academy of Physical Medicine and Rehabilitation, Interventional Orthobiolgoics Foundation, Spine Intervention Society, and the American Medical Society for Sports Medicine. When not in the office, Dr. Takyi enjoys photography, exercising, and spending time with his family.
Mahmud Ibrahim, MD, at Revive Spine and Pain Center Marlton, Hamilton Township, East Brunswick and Northfield, New Jersey, holds dual board certification in sports medicine and physical medicine and rehabilitation and is fellowship trained in interventional pain management.
When treating patients at Revive Spine and Pain Center, his goal is to restore function, reduce pain, and promote an active, healthy lifestyle using conservative measures whenever possible.
Though Dr. Ibrahim treats pain from any cause, his special clinical interests include musculoskeletal medicine, non-operative spine procedures, orthopedics, sports medicine, electrodiagnostic medicine, and restorative therapy.
In addition to performing the full range of fluoroscopic-guided interventional pain-management procedures, he also uses diagnostic and therapeutic ultrasound. He has extensive skill in minimally invasive procedures such as discectomies and percutaneous tenotomies.
After graduating from the New York University Grossman School of Medicine in New York City, Dr. Ibrahim completed his residency training in physical medicine and rehabilitation at the Icahn School of Medicine at Mount Sinai School (also in New York City). After receiving an Accreditation Council for Graduate Medical Education (ACGME) fellowship, he stayed at Mount Sinai to subspecialize in sports and interventional spine medicine.
Dr. Ibrahim has published several articles on musculoskeletal medicine. He’s also a contributing author in a textbook on how to perform ultrasound-guided injections and the author of a book exploring what causes pain, how to reduce it, and ways to live with persistent pain.
Dr. Ibrahim has provided sideline coverage at football games, captained the medical tents at the New York City marathon, and was a ringside physician for the Golden Gloves of America boxing tournament and professional wrestling.
Frank Colarusso, DO, is board-certified in physical medicine and rehabilitation at Mercer-Bucks Orthopaedics in Hamilton, Lawrenceville, and Princeton, New Jersey, and Langhorne, Pennsylvania.
Dr. Colarusso maintains double-board certification, having recently recertified with both the American Medical Association, the American Board of Physical Medicine & Rehabilitation, and the American Osteopathic Association. With an attention to detail and passion for continuing education, Dr. Colarusso is proud to provide comprehensive non-operative musculoskeletal, spine, and sports medicine.
He specializes in MSK neck and back pain, EMG services, acute and chronic pain syndromes with medication management, dry needling, Osteopathic Manual Manipulation treatments as well as ultrasound-guided injections, nerve blocks, and biologics.
After receiving honors at Rider University in Lawrenceville, New Jersey, and Philadelphia College of Osteopathic Medicine in Pennsylvania, Dr. Colarusso remained in Pennsylvania to intern at St. Barnabas Health Care System. He later was the chief resident in Physical Medicine and Rehabilitation at Boston University Medical Center in Massachusetts.
Previously serving as one of three attending physicians at the 15th largest rehabilitation hospitals in the United States, Dr. Colarusso is proud to serve new and returning patients from the Mercer-Bucks Orthopaedics offices.
Frank Colarusso, DO, is board-certified in physical medicine and rehabilitation at Mercer-Bucks Orthopaedics in Hamilton, Lawrenceville, and Princeton, New Jersey, and Langhorne, Pennsylvania.
Dr. Colarusso maintains double-board certification, having recently recertified with both the American Medical Association, the American Board of Physical Medicine & Rehabilitation, and the American Osteopathic Association. With an attention to detail and passion for continuing education, Dr. Colarusso is proud to provide comprehensive non-operative musculoskeletal, spine, and sports medicine.
He specializes in MSK neck and back pain, EMG services, acute and chronic pain syndromes with medication management, dry needling, Osteopathic Manual Manipulation treatments as well as ultrasound-guided injections, nerve blocks, and biologics.
After receiving honors at Rider University in Lawrenceville, New Jersey, and Philadelphia College of Osteopathic Medicine in Pennsylvania, Dr. Colarusso remained in Pennsylvania to intern at St. Barnabas Health Care System. He later was the chief resident in Physical Medicine and Rehabilitation at Boston University Medical Center in Massachusetts.
Previously serving as one of three attending physicians at the 15th largest rehabilitation hospitals in the United States, Dr. Colarusso is proud to serve new and returning patients from the Mercer-Bucks Orthopaedics offices.
Union Anesthesia Associates provides high-quality pain management to people with acute, chronic, and severe pain. At their offices in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey, the board-certified anesthesiologists and pain management specialists work closely with each person to find and treat the pain’s source rather than just masking symptoms.
At each office, you will receive a thorough evaluation, clinical exam, and review of diagnostic tests including MRIs to diagnose the root cause of your neck, spine, back pain, and any other ailments including headaches, nerve pain, and joint pain. The providers also offer comprehensive evaluations and treatments for all headaches, including cluster headaches and chronic migraines.
The Union Anesthesia Associates team has extensive experience managing acute and chronic pain conditions such as neck and back pain, herniated discs, sciatica, radiculopathy, neuropathy, spinal stenosis, arthritis, complex regional pain syndrome, joint pain, and nerve pain. They use medication management, anti-inflammatories, muscle relaxants, injectable anesthetics, and interventional pain management including epidural steroid injections, facet joint injections, radiofrequency ablation, nerve blocks, spinal cord stimulation, and minimally invasive surgery.
The highly skilled pain management specialists treat pain conditions caused by workplace injuries, motor vehicle accidents, and slip-and-fall events. They also provide personalized care for pain after surgery and complications such as failed back syndrome, postlaminectomy syndrome, adhesions, and phantom limb syndrome.
Minimally invasive spine surgery is available for chronic back and neck pain. Union Anesthesia Associates offers specialized procedures such as endoscopic surgery, and rhizotomy to ease the chronic pain or injuries associated with trauma and degenerative spine disorders. Spinal cord stimulation trials and permanent implantations are also available.
The Union Anesthesia Associates staff maintains a friendly, welcoming environment and offers flexible appointment times. The experienced physicians collaborate on all aspects of patient care to ensure a high level of pain management and the best treatment outcomes.
Call the Union Aesthetics Associates office near you today to schedule a consultation or book an appointment online.
Philip M. Rojo, MLP-NP, is a highly skilled nurse practitioner passionate about delivering customized care. Through his work at Union Spine and Pain Management, which has offices in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey, Philip helps patients feel more comfortable as they progress in treatment.
A lifelong learner, Philip earned a Bachelor of Science in nursing from Rutgers, The State University of New Jersey, in New Brunswick. He remains at Rutgers to complete a Master of Science in nursing, focusing on adult and geriatric care.
Philip is trained in basic life support and advanced cardiac life support. He is also certified as an adult/gerontology acute care nurse practitioner.
Philip’s professional experience includes working in emergency room settings and managing patient care across various crisis and trauma needs. He also brings experience in managing patient care after surgical interventions, in addition to treating numerous acute and chronic musculoskeletal pain disorders.
Philip enjoys working one-on-one with those in his care, getting to know them and their unique health needs. He finds his work deeply rewarding, especially when patients overcome significant challenges in pain management.
Marlyn Alvarado, FNP-C, is a board-certified family nurse practitioner at Union Spine and Pain Management. The practice has locations in Union, Scotch Plains, South Bound Brook, New Brunswick, Old Bridge, and Woodbridge, New Jersey. Proficient in English and Spanish, Marlyn brings a wealth of experience delivering comprehensive care to diverse populations of all ages.
Marlyn embarked on her nursing journey at New Jersey City University in Jersey City, where she earned her nursing degree. During this time, she served as a surgical nurse at Jersey City Medical Center in Jersey City, New Jersey, where she cared for patients undergoing chemotherapy, dialysis, and surgery.
Continuing her work at Jersey City Medical Center, Marlyn served in pivotal roles as a transition discharge nurse and maternal child health nurse. Here, she managed patients with high-risk pregnancies, substance use disorder, and teen pregnancy, demonstrating her versatility in addressing complex healthcare needs.
She also served as a case manager at United Healthcare in West New York, New Jersey, and later as a wellness coach/chronic condition manager at Premise Health. These roles further developed her understanding of holistic healthcare management and patient support.
Passionate about advancing her nursing practice, Marlyn pursued her Master of Science in nursing at Spring Arbor University in Spring Arbor, Michigan. This led to her family nurse practitioner certification from the American Academy of Nurse Practitioners.
Marlyn holds additional certifications in neonatal resuscitation from the American Academy of Pediatrics and advanced cardiac life support from the American Heart Association.
In her role at Union Spine and Pain Management, Marlyn enjoys collaborating with the team, ensuring that she meets the diverse needs of her patients.
