| NPI | 1508066317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2015013430) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: MO 2015013430) |
| 208000000X Pediatrics (Licence: MO 2015013430) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2021-11-15 |