| NPI | 1053593525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2008013983) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: MO 2008013983) |
| 208000000X Pediatrics (Licence: KS 04-33112) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: KS 04-33112) | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2011-06-17 |