| NPI | 1174044341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: CA A162846) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A162846) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: MA 274478) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2019-08-24 |