| NPI | 1144562562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MD D0083187) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 283223) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: MA 283223) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD D0083187) | |
| Enumeration Date | 2013-03-24 |
| Last Update Date | 2025-06-30 |