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 |