| NPI | 1174727655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 45911) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: TN 45911) |
| 208000000X Pediatrics (Licence: TN 45911) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: TN 45911) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-03-23 |