| NPI | 1528321569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: AZ 60285) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2017-02087) |
| 2080S0010X Pediatrics, Sports Medicine (Licence: NC 2017-02087) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-12-10 |