| NPI | 1316350366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD461642) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: DE C1-0024319) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: PA MD461642) | |
| Enumeration Date | 2014-06-07 |
| Last Update Date | 2022-08-08 |