| NPI | 1346775590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: CO 0073049) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 227261) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2024-08-05 |