| NPI | 1194810697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: CA A80301) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA a80301) |
| 208000000X Pediatrics (Licence: CA A80301) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-03-04 |