| NPI | 1124413489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T1358) |
| Additional Taxonomies | 2080S0010X Pediatrics Sports Medicine (Licence: TX T1358) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2023-08-15 |