| NPI | 1457615460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: DE C2-0013079) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: NJ 25mb09117500) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: PA OS019939) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2019-04-29 |