| NPI | 1215223144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: TN 67781) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q9868) |
| 208000000X Pediatrics (Licence: SC MMD.33843 LL) | |
| 208000000X Pediatrics (Licence: TN 67781) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2024-04-11 |