| NPI | 1376074435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: TX V9498) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: OH 34014437) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2025-10-08 |