| NPI | 1043949209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MO 2025030238) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 05-51562) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: KS 05-51562) | |
| 208000000X Pediatrics (Licence: MO 2025030238) | |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2025-12-02 |