| NPI | 1134413396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: FL ME121461) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME121461) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2016-06-02 |