| NPI | 1326400839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2020-02729) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 3741) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: NC 2020-02729) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-09-25 |