| NPI | 1255824603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WA MD61384121) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME MD24560) |
| 208000000X Pediatrics (Licence: MI 4301115052) | |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-04-26 |