| NPI | 1356603799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 262359) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA L-251884) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2016-05-23 |