| NPI | 1043636194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: WA OP60918494) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA OP60918494) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2022-10-17 |