| NPI | 1144617366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MN 63924) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MN 63924) |
| 208000000X Pediatrics (Licence: MN 63924) | |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2023-06-14 |