| NPI | 1023514056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MA 287799) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 287799) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2022-06-14 |