| NPI | 1417151382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD157316) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: OR MD157316) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2012-07-23 |